A systematic review of focused topics for the management of spinal cord injury and impairment

Size: px
Start display at page:

Download "A systematic review of focused topics for the management of spinal cord injury and impairment"

Transcription

1 A systematic review of focused topics for the management of spinal cord injury and impairment icahe, University of South Australia For the NZ Spinal Cord Impairment Strategy

2 Introduction This was the third report from icache that focuses on gaps identified from the prior evidential review work This is a summary of key points that are of high relevance to the SCI Strategy process

3 Gaps in understanding addressed 1. Speed of transfer and timeliness of initial treatment 2. Level of intensity of treatment/rehabilitation 3. Review and monitoring 4. Children s models of rehabilitation

4 Methods Extensive systematic literature search of secondary evidence Search included: 8 databases (Medline, EMBASE, CINAHL, Cochrane Databases, Scopus, Web of Science, Google Scholar) 6 Clinical guideline websites & 6 Grey literature sites Publications provided by ACC, and hand searching of reference lists

5 Methods Title and abstract searches were conducted using MeSH headings and key word text terms Secondary evidence was selected which met the project s inclusion criteria 5736 articles were identified in the search and narrowed to 75

6 Speed of transfer and timeliness of initial treatment When is the best time for a patient to be transferred to a spinal centre? In the case of multiple trauma, should patients be transferred to a spinal centre as soon as possible/once stable, or stay in a trauma hospital? What is the evidence for, and what should occur within 4 hour, 8 hour and 12 hour time frames, in the initial care of spinal cord patients?

7 Pre hospital triage & transportation Recommendations: Transportation of patients with acute or suspected traumatic SCI to the definitive hospital (SCI Centre) can safely occur within 24hrs of injury. Helicopter transportation is a safe option when required. Identify regional trauma centres & specialist resources for acute SCI & develop guidelines based on local resources.

8 SCI Centres (for traumatic injury) Recommendations & key points: Direct spinal cord injured patients expeditiously to a specialised acute multidisciplinary SCI centre (preferably within 48 hours of injury) Rationale: several Level 3 & 4 studies have found that patients cared for early in specialist SCI centres have reduced mortality, begin their rehabilitation program earlier, have fewer complications before & during rehabilitation, make more efficient functional gains during rehabilitation, decreased overall LOS

9 SCI Centres (for non traumatic SCI) Recommendations & key points: Patients with non traumatic spinal cord impairment may also benefit from care within specialist SCI Centres.

10 Timing of decompression & stabilisation surgery Recommendations & key points: Early surgical intervention (8 24 hours after acute injury) is safe and feasible, and can improve clinical and neurological outcomes and reduce health care costs Note this recommendation is supported by a high quality trial just published (Fehlings et al 2012)

11 What is the evidence for higher intensity rehabilitation for spinal cord impairment? Is there evidence to support higher intensity rehabilitation? Does more intense rehabilitation produce outcomes, e.g. earlier discharge or more effective rehabilitation in terms of increased functional outcomes and better social integration?

12 Rehabilitation intensity Evidence base: There is insufficient secondary evidence from SCI studies to make recommendations about rehabilitation intensity. No evidence was found for models of rehabilitation to increase rehabilitation intensity, such as 7 day services. Exercise intensity recommendations (Chronic SCI) appear in 1 high quality guideline & 2 systematic reviews Recommendations & key points for chronic SCI: Aerobic exercise and strength training be performed 2 3 times/week, should be of mod high intensity, at least 20 30minutes in duration Rehabilitation strategies that facilitate repeated practice of gait offer the greatest benefits to functional ambulation

13 Rehabilitation intensity: STROKE POPULATION Evidence base: Strong evidence exists for benefits of higher rehabilitation intensity in both the post acute and chronic phases after stroke. Recommendations & key points for stroke: Greater amounts of rehabilitation (practice time) and greater training intensity, can improve functional outcomes for stroke survivors Rehabilitation should be structured to provide as much practice as possible within the first six months after stroke (minimum 1hour practice/day, 5 days/week) Promote the practice of skills gained in therapy into the patient s daily routine

14 As people with a SCI age, there may be points on the continuum where greater input is required due to the increased likelihood of the secondary conditions/co morbidities from the impairment Is there evidence for models of shared care (GP and rehab centre) & how often should SCI clients be monitored/followed up? How frequently should the patient be reviewed? Is there evidence for the prevention or pre emptive treatment for secondary conditions? At which points in the life cycle of a person with SCI are interventions appropriate?

15 Review & monitoring by GPs Recommendations or key points: There is considerable duplication between primary care and rehabilitation consultants, but there is high satisfaction with both systems of care 52% of contact with GPs was regarding secondary complications, many of which are preventable Recommendations or key points Provide guidelines to GPs for a comprehensive programme of annual health review and monitoring

16 Review & monitoring by specialist SCI Centre Recommendations or key points An annual Comprehensive Preventive Health Evaluation conducted at an SCI centre improves health care utilization and meets health, psychosocial, and equipment needs Routine, comprehensive, specialist follow up services may improve perceived health and independence and reduce feelings of depression

17 Review & monitoring by specialist SCI Centre SCI Centres will provide a programme of life long follow up & support to prevent secondary complications, provide continuous assessment, provide appropriate further intervention and ongoing education The frequency of review is individualised according to need but is usually annual, and at no greater than 3 year intervals Specifies items to be addressed in the comprehensive review GPs have a supporting role only

18 Follow up by specialist outreach teams Recommendations or key points: Outreach in the form of home visits from a multidisciplinary team from the rehab centre, may lead to fewer re admissions and improved rehab outcomes A multi disciplinary Health Maintenance Education outreach programme may improve patient satisfaction with primary care and increases knowledge of SCI complications and community resources

19 Follow up using tele health Recommendations or key points Telemedicine videoconferencing, as an adjunct to routine follow up care, improves patient satisfaction and may lead to enhanced functional outcomes Rationale: Tele health is especially amenable to the provision of follow up care by centralised specialist services centralised, for patients as they return to their disparate communities and as they link with primary care practitioners, who often lack specialised knowledge about optimal SCI management.

20 Pain management Recommendations & key points: Evidence base for non pharmacological pain management is variable with good evidence for the use of some interventions (e.g. transcranial electrical stimulation) & poor evidence for others such as massage Good evidence for some medications Little evidence for surgical interventions for pain management No recommendations found for the frequency or mode of pain management review Rationale: Pain is a frequent complication of traumatic SCI with studies reporting an incidence from 48 94%. It is estimated that 30 40% of patients with SCI experience severe disabling pain.

21 Mental Health Recommendations & key points: Cognitive behavioural therapy is an effective intervention for depression, anxiety, adjustment, coping, assertiveness, quality of life, self efficacy, mood and chronic pain following SCI (meta analysis finding) Rationale: People with SCI have an increased risk of suffering debilitating levels of psychological morbidity.

22 Spinal deformity in children and adolescents with SCI Recommendations & key points: Children should be carefully monitored for the development of scoliosis and actively managed if this occurs Rationale: Children with traumatic spinal injuries are at particular risk of spinal deformity at the time of the adolescent growth spurt, while children with spina bifida may develop scoliosis at any age up to 15yrs

23 New SCI in older individuals Recommendations & key points: All older people with SCI should be referred to specialised SCI Centre promptly Older patients should be offered the same access rights to specialist SCI services as younger patients In light of higher mortality rates and lower levels of improvement despite longer rehabilitation stays, older people should be offered alternative services on an individual basis to enable them to return to their home/community as soon as possible

24 Ageing of body systems following SCI Recommendations & key points: Individuals with SCI undergo premature ageing processes This has implications for the monitoring and preventative health strategies required to optimise the health of the SCI population Strong evidence that the endocrine and musculoskeletal systems prematurely age following SCI Limited evidence that the respiratory, skin and subcutaneous tissues, genitourinary, and gastrointestinal systems may also undergo premature ageing

25 Rehabilitation of children with SCI What is the optimum time spent in specialist or rehabilitation centres? What is the role of the multidisciplinary team in transfers? What is the optimal time to discharge to the home setting? What is the evidence for outreach clinics in improving outcomes? What is the role out outreach clinics and the timing of follow up and monitoring?

26 Rehabilitation of children with SCI Recommendations & key points: Rehab of children following major trauma requires a systematic regional approach including: Communication/ liaison between trauma specialists, other specialist services, paediatric rehab team, community services, family paediatrician/gp, parents Rehabilitation should continue at the intensity required for as long as is necessary to optimise function Counsellor/ social worker to support families throughout the child s care pathway School re integration policy for children following major trauma

ISSUED BY: TITLE: ISSUED BY: TITLE: President

ISSUED BY: TITLE: ISSUED BY: TITLE: President CLINICAL PRACTICE GUIDELINE PROFESSIONAL PRACTICE TITLE: Stroke Care Rehabilitation Unit DATE OF ISSUE: 2005, 05 PAGE 1 OF 7 NUMBER: CPG 20-3 SUPERCEDES: New ISSUED BY: TITLE: Chief of Medical Staff ISSUED

More information

Joint ACC and Health Spinal Cord Impairment Initiative & Implementation Plan. Situation Analysis Paper 24 th February 2013.

Joint ACC and Health Spinal Cord Impairment Initiative & Implementation Plan. Situation Analysis Paper 24 th February 2013. Joint ACC and Health Spinal Cord Impairment Initiative & Implementation Plan Situation Analysis Paper 24 th February 2013 Prepared by Christine Howard Brown and Jo Esplin Contents Executive Summary...

More information

Good Samaritan Inpatient Rehabilitation Program

Good Samaritan Inpatient Rehabilitation Program Good Samaritan Inpatient Rehabilitation Program Living at your full potential. Welcome When people are sick or injured, our goal is their maximum recovery. We help people live to their full potential.

More information

The UK International Emergency Trauma Register The incorporation of rehabilitation professionals

The UK International Emergency Trauma Register The incorporation of rehabilitation professionals The UK International Emergency Trauma Register The incorporation of rehabilitation professionals Alice Harvey, BSc, MSc, MCSP Handicap International Overview Background to why rehabilitation is essential

More information

UW Hospital and Clinics (UWHC) Acute Rehabilitation served 358 individuals between January 2011 and December 2011.

UW Hospital and Clinics (UWHC) Acute Rehabilitation served 358 individuals between January 2011 and December 2011. Program Facts Program Facts The Program provides injury/illness-specific programs that offer patients care needed to regain the abilities to perform daily tasks, restore basic life skills, reclaim cognitive

More information

Pennsylvania Trauma Nursing Core Curriculum. Posted to PTSF Website: 10/30/2014

Pennsylvania Trauma Nursing Core Curriculum. Posted to PTSF Website: 10/30/2014 Pennsylvania Trauma Nursing Core Curriculum Posted to PTSF Website: 10/30/2014 PREFACE Care of the trauma patient has evolved since 1985, when the Pennsylvania Trauma Systems Foundation (PTSF) Board of

More information

CALVARY HEALTH CARE SYDNEY DAY REHABILITATION UNIT (DRU) JEREMEY HORNE

CALVARY HEALTH CARE SYDNEY DAY REHABILITATION UNIT (DRU) JEREMEY HORNE CALVARY HEALTH CARE SYDNEY DAY REHABILITATION UNIT (DRU) JEREMEY HORNE DAY REHABILITATION UNIT OVERVIEW What is a DRU Minimum requirements Calvary Day Rehabilitation Admission Criteria Type of Patients

More information

General Hospital Information

General Hospital Information Inpatient Programs General Hospital Information General Information The Melbourne Clinic is a purpose built psychiatric hospital established in 1975, intially privately owned by a group of psychiatrists

More information

Q: Rehabilitation Nursing

Q: Rehabilitation Nursing Q: Rehabilitation Nursing Alberta Licensed Practical Nurses Competency Profile 163 Priority: One Competency: Q-1 Apply the Rehabilitation Process Q-1-1 Q-1-2 Q-1-3 Q-1-4 Q-1-5 Q-1-6 Demonstrate knowledge

More information

REHABILITATION MEDICINE by PROFESSOR ANTHONY WARD

REHABILITATION MEDICINE by PROFESSOR ANTHONY WARD REHABILITATION MEDICINE by PROFESSOR ANTHONY WARD What is Rehabilitation Medicine? Rehabilitation Medicine (RM) is the medical specialty with rehabilitation as its primary strategy. It provides services

More information

Brief, Evidence Based Review of Inpatient/Residential rehabilitation for adults with moderate to severe TBI

Brief, Evidence Based Review of Inpatient/Residential rehabilitation for adults with moderate to severe TBI Brief, Evidence Based Review of Inpatient/Residential rehabilitation for adults with moderate to severe TBI Reviewer Peter Larking Date Report Completed 7 October 2011 Important Note: This brief report

More information

Is manual physical therapy more effective than other physical therapy approaches in reducing pain and disability in adults post whiplash injury?

Is manual physical therapy more effective than other physical therapy approaches in reducing pain and disability in adults post whiplash injury? Is manual physical therapy more effective than other physical therapy approaches in reducing pain and disability in adults post whiplash injury? Clinical Bottom Line Manual therapy may have a role in the

More information

Top Ten Priorities for Stroke Services Research A summary of an analysis of Research for the National Stroke Strategy

Top Ten Priorities for Stroke Services Research A summary of an analysis of Research for the National Stroke Strategy The Stroke Strategy confirmed that the Department would commission a short analysis of research evidence in relation to the strategy and the top ten research areas identified in it. We said that we would

More information

The Hunter experience Lessons Learned: National Disability Insurance Scheme (NDIS)

The Hunter experience Lessons Learned: National Disability Insurance Scheme (NDIS) The Hunter experience Lessons Learned: National Disability Insurance Scheme (NDIS) Prepared by: Hunter Spinal Cord Injury Service Presented by: Kylie Jones, Service Manager National Disability Insurance

More information

Child & Adolescent Rehabilitation Services (CARS)

Child & Adolescent Rehabilitation Services (CARS) Child & Adolescent Rehabilitation Services (CARS) Operational Guidelines To be read in conjunction with the CARS contract June 2013 This is a living document and will be updated as required Contents Child

More information

Stakeholder s Report. 2525 SW 75 th Ave Miami, Florida 33155 305.262.6800 www.westgablesrehabhospital.com

Stakeholder s Report. 2525 SW 75 th Ave Miami, Florida 33155 305.262.6800 www.westgablesrehabhospital.com 212 Stakeholder s Report 2525 SW 75 th Ave Miami, Florida 33155 35.262.68 www.westgablesrehabhospital.com PROFILE REPORT For more than 25 years, West Gables Rehabilitation Hospital has made a mission of

More information

Guidelines for Medical Necessity Determination for Occupational Therapy

Guidelines for Medical Necessity Determination for Occupational Therapy Guidelines for Medical Necessity Determination for Occupational Therapy These Guidelines for Medical Necessity Determination (Guidelines) identify the clinical information MassHealth needs to determine

More information

Rehabilitation. Day Programs

Rehabilitation. Day Programs Rehabilitation Day Programs Healthe Care is the hospital division of Healthe. As the largest privately owned network of private hospitals in Australia, we take pride in delivering premium care to our valued

More information

Interdisciplinary Care in Pediatric Chronic Pain

Interdisciplinary Care in Pediatric Chronic Pain + Interdisciplinary Care in Pediatric Chronic Pain Emily Law, PhD Assistant Professor Department of Anesthesiology & Pain Medicine University of Washington & Seattle Children s Hospital + Efficacy: Psychological

More information

SECTION B THE SERVICES COMMUNITY STROKE REHABILITATION SPECIFICATION 20XX/YY

SECTION B THE SERVICES COMMUNITY STROKE REHABILITATION SPECIFICATION 20XX/YY SECTION B THE SERVICES COMMUNITY STROKE REHABILITATION SPECIFICATION 20XX/YY SECTION B PART 1 - SERVICE SPECIFICATIONS Service specification number Service Commissioner Lead Provider Lead Period Date of

More information

REHABILITATION SERVICES

REHABILITATION SERVICES REHABILITATION SERVICES Table of Contents GENERAL... 2 TERMS AND ABBREVIATIONS... 2 PRIOR AUTHORIZATION REQUIREMENTS FOR MEDICAID REIMBURSEMENT OF INPATIENT REHABILITATION SERVICES (Updated 4/1/11)...

More information

Appendix A - Low Back Pain Scope

Appendix A - Low Back Pain Scope Appendix A - Low Back Pain Scope Low back pain: full guideline DRAFT (September 2008) Page 1 of 10 NATIONAL INSTITUTE FOR HEALTH AND CLINICAL EXCELLENCE 1 Guideline title SCOPE Low back pain: the acute

More information

St Vincent s Hospital Sydney Referral to Sacred Heart Rehabilitation Consultation Service Policy Section 1 Policy 32

St Vincent s Hospital Sydney Referral to Sacred Heart Rehabilitation Consultation Service Policy Section 1 Policy 32 Subject: Referral to the Sacred Heart Rehabilitation Consultation Service Area: Hospital wide Classification: Operational Relevant to: All clinical staff Implementation date: October 2003 Review Date:

More information

National Clinical Programmes

National Clinical Programmes National Clinical Programmes Section 3 Background information on the National Clinical Programmes Mission, Vision and Objectives July 2011 V0. 6_ 4 th July, 2011 1 National Clinical Programmes: Mission

More information

Step 4: Complex and severe depression in adults

Step 4: Complex and severe depression in adults Step 4: Complex and severe depression in adults A NICE pathway brings together all NICE guidance, quality standards and materials to support implementation on a specific topic area. The pathways are interactive

More information

Your local specialist mental health services

Your local specialist mental health services Your local specialist mental health services Primary Care Liaison Service B&NES Primary Care Mental Health Liaison service is a short-term support service to help people with mental health difficulties

More information

Chapter. CPT only copyright 2009 American Medical Association. All rights reserved. 29Physical Medicine and Rehabilitation

Chapter. CPT only copyright 2009 American Medical Association. All rights reserved. 29Physical Medicine and Rehabilitation Chapter 29Physical Medicine and Rehabilitation 29 29.1 Enrollment...................................................... 29-2 29.2 Benefits, Limitations, and Authorization Requirements......................

More information

Early Response Concussion Recovery

Early Response Concussion Recovery Early Response Concussion Recovery KRISTA MAILEY, BSW RSW, CONCUSSION RECOVERY CONSULTANT CAREY MINTZ, PH.D., C. PSYCH., PRACTICE IN CLINICAL NEUROPSYCHOLOGY FOR REFERRAL: Contact Krista Mailey at (204)

More information

FRESNO/KINGS/MADERA EMERGENCY MEDICAL SERVICES

FRESNO/KINGS/MADERA EMERGENCY MEDICAL SERVICES FRESNO/KINGS/MADERA EMERGENCY MEDICAL SERVICES HEALTH SERVICES AGENCY POLICIES AND PROCEDURES Manual Subject References Emergency Medical Services Administrative Policies and Procedures Pediatric Critical

More information

PREPARING THE PATIENT FOR TRANSFER TO AN INPATIENT REHABILITATON FACILITY (IRF) University Hospitals 8th Annual Neuroscience Nursing Symposium

PREPARING THE PATIENT FOR TRANSFER TO AN INPATIENT REHABILITATON FACILITY (IRF) University Hospitals 8th Annual Neuroscience Nursing Symposium PREPARING THE PATIENT FOR TRANSFER TO AN INPATIENT REHABILITATON FACILITY (IRF) University Hospitals 8th Annual Neuroscience Nursing Symposium May 31, 2013 2 DEFINITION: INPATIENT REHABILITATION FACILITY

More information

CURRICULUM VITAE. JEAN TAYLOR, B.Sc.(Hons. Kin.) Registered Kinesiologist PROFESSIONAL EXPERIENCE

CURRICULUM VITAE. JEAN TAYLOR, B.Sc.(Hons. Kin.) Registered Kinesiologist PROFESSIONAL EXPERIENCE CURRICULUM VITAE JEAN TAYLOR, B.Sc.(Hons. Kin.) Registered Kinesiologist PROFESSIONAL EXPERIENCE ABI Clinical Consultant ABI Transitional Living Program August 2013 to Present Design, develop and implement

More information

Victorian Nurse Practitioner Project Phase 4, Round 4.11 - Chronic Disease Management

Victorian Nurse Practitioner Project Phase 4, Round 4.11 - Chronic Disease Management Victorian Nurse Practitioner Project Phase 4, Round 4.11 - Chronic Disease Management Eastern Health Multiple Sclerosis Nurse Practitioner Service Model April 2014 Prepared by Jodi Haartsen and Deanna

More information

Adult Spine Rotation Specific Evaluation Orthopaedic Surgery Training Program School of Medicine, Queen s University

Adult Spine Rotation Specific Evaluation Orthopaedic Surgery Training Program School of Medicine, Queen s University Adult Spine Rotation Specific Evaluation Orthopaedic Surgery Training Program School of Medicine, Queen s University CanMEDS Roles / Competencies Name: PGY Rotation Dates: s s Exceeds N/A Attending Staff:

More information

STROKE REHABILITATION RESOURCE GUIDE

STROKE REHABILITATION RESOURCE GUIDE STROKE REHABILITATION RESOURCE GUIDE INTRODUCTION The intent of the Stroke Rehabilitation Guide is to enable stroke care providers seeking information related to the rehabilitation of the stroke survivor

More information

Chapter. CPT only copyright 2010 American Medical Association. All rights reserved. 29Physical Medicine and Rehabilitation

Chapter. CPT only copyright 2010 American Medical Association. All rights reserved. 29Physical Medicine and Rehabilitation 29Physical Medicine and Rehabilitation Chapter 29 29.1 Enrollment..................................................................... 29-2 29.2 Benefits, Limitations, and Authorization Requirements...........................

More information

Annual Outcome Comparison Report-Source One/Village Jan 1, thru Dec 31, 2013

Annual Outcome Comparison Report-Source One/Village Jan 1, thru Dec 31, 2013 1 SOURCE ONE REHAB Annual Outcome Comparison Report-Source One/Village Jan 1, thru Dec 31, 2013 This report was presented to the stakeholders and Board of Directors. Index to this report: Overall program

More information

AMERICAN BURN ASSOCIATION BURN CENTER VERIFICATION REVIEW PROGRAM Verificatoin Criterea EFFECTIVE JANUARY 1, 2015. Criterion. Level (1 or 2) Number

AMERICAN BURN ASSOCIATION BURN CENTER VERIFICATION REVIEW PROGRAM Verificatoin Criterea EFFECTIVE JANUARY 1, 2015. Criterion. Level (1 or 2) Number Criterion AMERICAN BURN ASSOCIATION BURN CENTER VERIFICATION REVIEW PROGRAM Criterion Level (1 or 2) Number Criterion BURN CENTER ADMINISTRATION 1. The burn center hospital is currently accredited by The

More information

Profile: Kessler Patients

Profile: Kessler Patients Profile: Kessler Patients 65 Breakthrough Years Kessler Institute has pioneered the course of medical rehabilitation since 1948. Today, as the nation s largest single rehabilitation hospital, we continue

More information

Fact Sheet. Queensland Spinal Cord Injuries Service. Pain Management Following Spinal Cord Injury for Health Professionals

Fact Sheet. Queensland Spinal Cord Injuries Service. Pain Management Following Spinal Cord Injury for Health Professionals Pain Management Following Injury for Health Professionals and Introduction Pain is a common problem following SCI. In the case where a person with SCI does have pain, there are treatments available that

More information

CLINICAL PRACTICE GUIDELINES Treatment of Schizophrenia

CLINICAL PRACTICE GUIDELINES Treatment of Schizophrenia CLINICAL PRACTICE GUIDELINES Treatment of Schizophrenia V. Service Delivery Service Delivery and the Treatment System General Principles 1. All patients should have access to a comprehensive continuum

More information

Hamilton Health Sciences Acquired Brain Injury Program

Hamilton Health Sciences Acquired Brain Injury Program Overview of Program The Acquired Brain Injury (ABI) Program at the Regional Rehabilitation Centre, Hamilton General Hospital serve the rehabilitation needs of adults with acquired brain injuries and their

More information

Traumatic Brain Injury

Traumatic Brain Injury Traumatic Rehabilitation s Page 1 of 5 MyCraig.org Website for Alums Site Map Help Home Campus Map Colorado and Denver Area Directions To Craig Local Flower Shops Nearby Accommodations Quick Photo Tour

More information

Community health care services Alternatives to acute admission & Facilitated discharge options. Directory

Community health care services Alternatives to acute admission & Facilitated discharge options. Directory Community health care services Alternatives to acute admission & Facilitated discharge options Directory Introduction The purpose of this directory is to provide primary and secondary health and social

More information

A BETTER TOMOR W. A balanced approach to Occupational Therapy & Case Management REHAB OPTIONS

A BETTER TOMOR W. A balanced approach to Occupational Therapy & Case Management REHAB OPTIONS A BETTER TOMOR W Beech House, 54b High Street, Chapmanslade, Wiltshire, BA13 4AN T: 01373 832459 info@rehaboptions.co.uk www.rehaboptions.co.uk Registered in England & Wales No 5860678 Designed by Plum

More information

Henriëtte van der Horst VUmc Head of Department of General Practice and Elderly Care Medicine

Henriëtte van der Horst VUmc Head of Department of General Practice and Elderly Care Medicine MUS and psychiatry in primary care Henriëtte van der Horst VUmc Head of Department of General Practice and Elderly Care Medicine Double Dutch: two topics Major changes in the mental health care organisation

More information

A Rapidly Growing Population with. - Murray Goldstein, DO, MPH Chairman, Cerebral Palsy International Research CPIRF

A Rapidly Growing Population with. - Murray Goldstein, DO, MPH Chairman, Cerebral Palsy International Research CPIRF Adults with Cerebral Palsy A Rapidly Growing Population with Complex Health Issues - Murray Goldstein, DO, MPH Chairman, Cerebral Palsy International Research Foundation Scientific Advisory Council CPIRF

More information

Redford Court, Liverpool

Redford Court, Liverpool Redford Court, Liverpool BIRT - the charity leading brain injury rehabilitation across the UK Registered Charity Nos. 800797-1 in England and Wales and SCO43579 in Scotland We aim to provide the best quality

More information

RE: THO North Cardiac Health and Rehabilitation Submission on the Green Paper

RE: THO North Cardiac Health and Rehabilitation Submission on the Green Paper One Health System, Better Outcomes Department of Health and Human Services, GPO Box 125, Hobart, TAS, 7001 RE: THO North Cardiac Health and Rehabilitation Submission on the Green Paper The Cardiac Health

More information

Delivering Appropriate Emergency Care Services - Protocol Development and Design

Delivering Appropriate Emergency Care Services - Protocol Development and Design Delivering Appropriate Emergency Care Services - Protocol Development and Design Sherrill Evans, Karen Evans, Peter Huxley, Helen Snooks, Ian Russell et al Mental Health Research Team, College of Human

More information

One step closer to home

One step closer to home One step closer to home Post-hospital short-term rehabilitation and sub-acute care at The Valley View Center for Nursing Care and Rehabilitation Helping to ensure a smooth transition Prior to discharge,

More information

New York State Workers' Comp Board. Mid and Lower Back Treatment Guidelines. Summary From 1st Edition, June 30, 2010. Effective December 1, 2010

New York State Workers' Comp Board. Mid and Lower Back Treatment Guidelines. Summary From 1st Edition, June 30, 2010. Effective December 1, 2010 New York State Workers' Comp Board Mid and Lower Back Treatment Guidelines Summary From 1st Edition, June 30, 2010 Effective December 1, 2010 General Principles Treatment should be focused on restoring

More information

Guide for Health Professionals on the Psychosocial Care of Adults with Spinal Cord Injury

Guide for Health Professionals on the Psychosocial Care of Adults with Spinal Cord Injury Guide for Health Professionals on the Psychosocial Care of Adults with Spinal Cord Injury Authors: Ashley Craig Rehabilitation Studies Unit, Sydney Medical School Northern, The University of Sydney Kathryn

More information

Outpatient/Ambulatory Rehab. Dedicated Trans-disciplinary Team (defined within Annotated References)

Outpatient/Ambulatory Rehab. Dedicated Trans-disciplinary Team (defined within Annotated References) CARDIAC The delivery of Cardiac Rehab is unlike most other rehab populations. The vast majority of patients receive their rehab in outpatient or community settings and only a small subset requires an inpatient

More information

REHABILITATION. begins right here

REHABILITATION. begins right here REHABILITATION begins right here Select Rehabilitation Hospital of Denton offers you a new direction in medical rehabilitation. Our 44-bed, state-of-the-science hospital offers unparalleled treatment to

More information

Acquired Brain Injury Program Regional Rehabilitation Centre at the Hamilton General Hospital

Acquired Brain Injury Program Regional Rehabilitation Centre at the Hamilton General Hospital ` Acquired Brain Injury Program Regional Rehabilitation Centre at the Hamilton General Hospital Table of Contents Page Introduction... 3-4 Acquired Brain Injury Program Philosophy... 3 Vision... 3 Service

More information

ALBERTA PROVINCIAL STROKE STRATEGY (APSS)

ALBERTA PROVINCIAL STROKE STRATEGY (APSS) ALBERTA PROVINCIAL STROKE STRATEGY (APSS) Stroke Systems of Care Key Components APSS Pillar Recommendations March 28, 2007 1 The following is a summary of the key components and APSS Pillar recommendations

More information

Farooq.A.Rathore. Department of Rehabilitation Medicine Combined Military Hospital PanoAqil Cantt, Pakistan. Member, ISPRM Assembly of Delegates

Farooq.A.Rathore. Department of Rehabilitation Medicine Combined Military Hospital PanoAqil Cantt, Pakistan. Member, ISPRM Assembly of Delegates Farooq.A.Rathore Department of Rehabilitation Medicine Combined Military Hospital PanoAqil Cantt, Pakistan Member, ISPRM Assembly of Delegates Farooq.A.Rathore MD Jianan Li, MD Jan D. Reinhardt, PhD Andrew

More information

Rehabilitation Medicine Programme

Rehabilitation Medicine Programme Update Report HiPE data from 2010 shows that approximately 30,000 individuals discharged from hospital presented with a neurological condition and/or amputation. Of these, it is likely that 50% should

More information

Post-Doctoral Fellowship in Rehabilitation Psychology

Post-Doctoral Fellowship in Rehabilitation Psychology Post-Doctoral Fellowship in Rehabilitation Psychology Psychology Services Training Director: Seema Eichler Weinstein, Ph.D. Manager, Psychology Services Application process: (1) Applicants must have completed

More information

Guidelines for the Operation of Burn Centers

Guidelines for the Operation of Burn Centers C h a p t e r 1 4 Guidelines for the Operation of Burn Centers............................................................. Each year in the United States, burn injuries result in more than 500,000 hospital

More information

Spinal cord stimulation

Spinal cord stimulation Spinal cord stimulation This leaflet aims to answer your questions about having spinal cord stimulation. It explains the benefits, risks and alternatives, as well as what you can expect when you come to

More information

ADULT HEALTH AND WELLBEING LONG-TERM NEUROLOGICAL CONDITIONS

ADULT HEALTH AND WELLBEING LONG-TERM NEUROLOGICAL CONDITIONS ADULT HEALTH AND WELLBEING LONG-TERM NEUROLOGICAL CONDITIONS i. Summary The National Service Framework for long-term neurological conditions categorises neurological conditions as: Sudden-onset conditions

More information

Alcohol Disorders in Older Adults: Common but Unrecognised. Amanda Quealy Chief Executive Officer The Hobart Clinic Association

Alcohol Disorders in Older Adults: Common but Unrecognised. Amanda Quealy Chief Executive Officer The Hobart Clinic Association Alcohol Disorders in Older Adults: Common but Unrecognised Amanda Quealy Chief Executive Officer The Hobart Clinic Association The Hobart Clinic Association Not-for-profit private Mental Health Service

More information

Functional recovery of hip fracture patients

Functional recovery of hip fracture patients Functional recovery of hip fracture patients Lauren Beaupre July 7, 2011 ABSTRACT Hip fractures are common in the older population and are associated with loss of independence as well as high morbidity

More information

Expert Witness Services for Personal Injury Lawyers

Expert Witness Services for Personal Injury Lawyers Advanced Assessments Ltd Expert witnesses and Psychologists A Member of the Strategic Enterprise Group 180 Piccadilly, London, W1J 9HP T: 0845 130 5717 Expert Witness Services for Personal Injury Lawyers

More information

Stroke rehabilitation

Stroke rehabilitation Costing report Stroke rehabilitation Published: June 2013 http://guidance.nice.org.uk/cg162 This costing report accompanies the clinical guideline: Stroke rehabilitation (available online at http://guidance.nice.org.uk/cg162).

More information

THE ACQUIRED BRAIN INJURY STRATEGY FOR GRAMPIAN.

THE ACQUIRED BRAIN INJURY STRATEGY FOR GRAMPIAN. THE ACQUIRED BRAIN INJURY STRATEGY FOR GRAMPIAN. 2011-2016 * 1 January 2011. Contents 1. Executive Summary 2. Progress and Developments since Grampian BI Strategy 2004-2010 3. Definitions and Epidemiology

More information

NICE: REHABILITATION AFTER STROKE GUIDELINE. Sue Thelwell Stroke Services Co-ordinator UHCW NHS Trust

NICE: REHABILITATION AFTER STROKE GUIDELINE. Sue Thelwell Stroke Services Co-ordinator UHCW NHS Trust NICE: REHABILITATION AFTER STROKE GUIDELINE Sue Thelwell Stroke Services Co-ordinator UHCW NHS Trust Content About me! NICE Rehabilitation after Stroke to include background, remit and scope, guideline

More information

Age-friendly principles and practices

Age-friendly principles and practices Age-friendly principles and practices Managing older people in the health service environment Developed on behalf of the Australian Health Ministers Advisory Council (AHMAC) by the AHMAC Care of Older

More information

Shepherd Center is a world-renowned provider of comprehensive, specialized rehabilitation for people with spinal cord injury, brain injury or stroke.

Shepherd Center is a world-renowned provider of comprehensive, specialized rehabilitation for people with spinal cord injury, brain injury or stroke. Shepherd Center is a world-renowned provider of comprehensive, specialized rehabilitation for people with spinal cord injury, brain injury or stroke. Table of Contents 1 HOPE is HERE 2 Why choose Shepherd

More information

STANDARDS. for the provision of. Inpatient Adult Rehabilitation Medicine Services. Public and Private Hospitals

STANDARDS. for the provision of. Inpatient Adult Rehabilitation Medicine Services. Public and Private Hospitals Australasian Faculty of Rehabilitation Medicine STANDARDS for the provision of Inpatient Adult Rehabilitation Medicine Services in Public and Private Hospitals 2011 Telephone (02) 9256 5420 145 Macquarie

More information

Working Together for Better Mental Health

Working Together for Better Mental Health Working Together for Better Mental Health One in five Australian adults experience some form of mental illness each year. It can affect people of all ages and from all walks of life. The causes may be

More information

Measures for the Australian health system. Belinda Emms Health Care Safety and Quality Unit Australian Institute of Health and Welfare

Measures for the Australian health system. Belinda Emms Health Care Safety and Quality Unit Australian Institute of Health and Welfare Measures for the Australian health system Belinda Emms Health Care Safety and Quality Unit Australian Institute of Health and Welfare Two sets of indicators The National Safety and Quality Indicators Performance

More information

Data Report on Spinal Cord Injury

Data Report on Spinal Cord Injury Indiana State Department of Health Injury Prevention Program Data prepared by Jodi Hackworth and Joan Marciniak December 12, 27 DATA HIGHLIGHTS Data Report on Spinal Cord Injury The leading cause of spinal

More information

Victorian Paediatric Rehabilitation Service model of care

Victorian Paediatric Rehabilitation Service model of care Victorian Paediatric Rehabilitation Service model of care 4 Clinical review of area mental health services 1997-2004 Intensive care for adults in Victorian public hospitals 2003 i Victorian Paediatric

More information

Patients with chronic low back pain will be considered for surgical management under the following circumstances:

Patients with chronic low back pain will be considered for surgical management under the following circumstances: T17 Spinal Surgery for Non Acute Lumbar Conditions Policy Policy author: Ipswich and East Suffolk and West Suffolk CCGs Policy start date: September 2014 Review date: September 2016 Policy summary This

More information

Does discharge planning prevent readmission to inpatient psychiatric units?

Does discharge planning prevent readmission to inpatient psychiatric units? Does planning prevent readmission to inpatient psychiatric units? Prepared by: Holly Missio Occupational Therapist - Central Coast Health Date: November, 2002 Review Date: November, 2004 Clinical Question

More information

Cheshire and Merseyside Rehabilitation Network Referral Criteria

Cheshire and Merseyside Rehabilitation Network Referral Criteria Cheshire and Merseyside Rehabilitation Network Referral Criteria Date Approved: September 2014 Effective From: September 2014 Review Date: August 2015 1. Rehabilitation Definition Rehabilitation is an

More information

Early Intervention, Injury Resolution & Sustainable RTW Outcomes. Presented by: Mr. Fred Cicchini, Chief Operations Manager September 2013

Early Intervention, Injury Resolution & Sustainable RTW Outcomes. Presented by: Mr. Fred Cicchini, Chief Operations Manager September 2013 Early Intervention, Injury Resolution & Sustainable RTW Outcomes. Presented by: Mr. Fred Cicchini, Chief Operations Manager September 2013 Session Objectives Early Intervention in the RTW Context Injury

More information

LOW BACK INJURIES PROGRAM OF CARE PROGRAM OF CARE 4TH EDITION 2014

LOW BACK INJURIES PROGRAM OF CARE PROGRAM OF CARE 4TH EDITION 2014 LOW BACK INJURIES PROGRAM OF CARE PROGRAM OF CARE 4TH EDITION 2014 GUIDE Acknowledgements Acknowledgements The WSIB would like to acknowledge the significant contributions of the following regulated Health

More information

Workplace Safety and Insurance Board (WSIB)

Workplace Safety and Insurance Board (WSIB) Workplace Safety and Insurance Board (WSIB) Dr. L. Grbac March 25, 2013 1 ASSESSMENT AND TREATMENT RESOURCES Programs of Care Specialty Clinics Low Back Expert Physician Examiner Assessments Regional Evaluation

More information

ISCRR Improving Trauma Care Theme Spinal Cord Injury Projects

ISCRR Improving Trauma Care Theme Spinal Cord Injury Projects ISCRR Improving Trauma Care Theme Spinal Cord Injury Projects Project Title: Improving Health After Spinal Injury: Bowel Management Research Project Leaders: Dr Brid Callaghan, Prof John Furness End Date:

More information

TORONTO STROKE FLOW INITIATIVE - Outpatient Rehabilitation Best Practice Recommendations Guide (updated July 26, 2013)

TORONTO STROKE FLOW INITIATIVE - Outpatient Rehabilitation Best Practice Recommendations Guide (updated July 26, 2013) Objective: To enhance system-wide performance and outcomes for persons with stroke in Toronto. Goals: Timely access to geographically located acute stroke unit care with a dedicated interprofessional team

More information

Borderline personality disorder

Borderline personality disorder Borderline personality disorder Treatment and management Issued: January 2009 NICE clinical guideline 78 guidance.nice.org.uk/cg78 NICE 2009 Contents Introduction... 3 Person-centred care... 5 Key priorities

More information

IMPROVING YOUR EXPERIENCE

IMPROVING YOUR EXPERIENCE Comments trom the Aberdeen City Joint Futures Brain Injury Group The Aberdeen City Joint Futures Brain Injury Group is made up of representatives from health (acute services, rehabilitation and community),

More information

The New Complex Patient. of Diabetes Clinical Programming

The New Complex Patient. of Diabetes Clinical Programming The New Complex Patient as Seen Through the Lens of Diabetes Clinical Programming 1 Valerie Garrett, M.D. Medical Director, Diabetes Center at Mission Health System Nov 6, 2014 Diabetes Health Burden High

More information

Taming Medical Cost Inflation

Taming Medical Cost Inflation Taming Medical Cost Inflation How to Combat the Rising Costs Associated with Workers Compensation Claims During the past decade, medical costs associated with workers compensation claims have risen dramatically.

More information

This specification must be read along with the overarching specification which applies to all services

This specification must be read along with the overarching specification which applies to all services This specification must be read along with the overarching specification which applies to all services 1. Population Needs 1.1 National / local context and evidence base National Context Local Context

More information

The diagnosis of dementia for people living in care homes. Frequently Asked Questions by GPs

The diagnosis of dementia for people living in care homes. Frequently Asked Questions by GPs The diagnosis of dementia for people living in care homes Frequently Asked Questions by GPs A discussion document jointly prepared by Maggie Keeble, GP with special interest in palliative care and older

More information

NICE Pathways bring together all NICE guidance, quality standards and other NICE information on a specific topic.

NICE Pathways bring together all NICE guidance, quality standards and other NICE information on a specific topic. bring together all NICE guidance, quality standards and other NICE information on a specific topic. are interactive and designed to be used online. They are updated regularly as new NICE guidance is published.

More information

Get Back to the Life You Love! The MedStar Spine Center in Chevy Chase

Get Back to the Life You Love! The MedStar Spine Center in Chevy Chase Get Back to the Life You Love! The MedStar Spine Center in Chevy Chase The MedStar Spine Center in Chevy Chase Relief from Pain, Restoration of Function Non-surgical, Minimally Invasive and Complex Surgical

More information

Chapter 4 Health Care Management Unit 1: Care Management

Chapter 4 Health Care Management Unit 1: Care Management Chapter 4 Health Care Unit 1: Care In This Unit Topic See Page Unit 1: Care Care 2 6 Emergency 7 4.1 Care Healthcare Healthcare (HMS), Highmark Blue Shield s medical management division, is responsible

More information

Case Management and Care Coordination:

Case Management and Care Coordination: HEALTH MANAGEMENT CUP recognizes the importance of promoting effective health management and preventive care for conditions that are relevant to our populations, thereby improving health care outcomes.

More information

3 LOCATION: JORDANSTOWN/COLERAINE/MAGEE CAMPUS ONE (certain modules) 5 FINAL AWARD: BSc Honours in Specialist Nursing Practice

3 LOCATION: JORDANSTOWN/COLERAINE/MAGEE CAMPUS ONE (certain modules) 5 FINAL AWARD: BSc Honours in Specialist Nursing Practice COURSE TITLE: BSc Hons IN SPECIALIST NURSING PRACTICE 1 AWARDING INSTITUTION/BODY: UNIVERSITY OF ULSTER 2 TEACHING INSTITUTION: UNIVERSITY OF ULSTER 3 LOCATION: JORDANSTOWN/COLERAINE/MAGEE CAMPUS ONE (certain

More information

SEPT Clinical Health Psychology Service. Clinical Lead: Dr Greg Wood, Consultant

SEPT Clinical Health Psychology Service. Clinical Lead: Dr Greg Wood, Consultant SEPT Clinical Health Psychology Service SOUTH ESSEX QIPP PROJECT Clinical Lead: Dr Greg Wood, Consultant Clinical Psychologist Clinical Health Psychology Initiatives Proposals posited locally: identified

More information

EUROPEAN BOARD OF PHYSICAL AND REHABILITATION MEDICINE LOGBOOK EUROPEAN UNION OF MEDICAL SPECIALISTS UEMS

EUROPEAN BOARD OF PHYSICAL AND REHABILITATION MEDICINE LOGBOOK EUROPEAN UNION OF MEDICAL SPECIALISTS UEMS EUROPEAN BOARD OF PHYSICAL AND REHABILITATION MEDICINE LOGBOOK EUROPEAN UNION OF MEDICAL SPECIALISTS UEMS IDENTIFICATION... 2 INSTRUCTIONS FOR USE... 3 THE TRAINING COURSE... 3 TRAINING PROGRAMME... 4

More information

Student Mental Health and Wellbeing

Student Mental Health and Wellbeing Student Mental Health and Wellbeing 2 Student Mental Health and Wellbeing DECS Commitment to Student Mental Health and Wellbeing The Department of Education and Children s Services (DECS) recognises that

More information

Low Back Pain (LBP) Tier 2 Assessment

Low Back Pain (LBP) Tier 2 Assessment Low Back Pain (LBP) Tier 2 Assessment In confidence Committee report number 2015165 Low Back Pain (LBP) Tier 2 Assessment Paper for meeting on: 2 September 2015 NHC reference: Executive summary Action

More information

NEUROLOGICAL REHABILITATION A Briefing Paper for Commissioners of Clinical Neurosciences

NEUROLOGICAL REHABILITATION A Briefing Paper for Commissioners of Clinical Neurosciences NEUROLOGICAL REHABILITATION A Briefing Paper for Commissioners of Clinical Neurosciences British Society of Rehabilitation Medicine C/o Royal College of Physicians, 11 St Andrews Place, London NW1 4LE

More information

NHS outcomes framework and CCG outcomes indicators: Data availability table

NHS outcomes framework and CCG outcomes indicators: Data availability table NHS outcomes framework and CCG outcomes indicators: Data availability table December 2012 NHS OF objectives Preventing people from dying prematurely DOMAIN 1: preventing people from dying prematurely Potential

More information